超声斑点追踪显像技术评价高血压前期患者左心房功能的价值

The Value of Ultrasound Speckle Tracking Imaging in Evaluating Left Atrial Function of Patients with Prehypertension

目的探讨超声斑点追踪显像技术在评价高血压前期患者左心房功能的价值。方法选取2012年3月—2013年3月在惠州市第三人民医院进行超声心动图检查的96例高血压患者(高血压组)和103例高血压前期患者(高血压前期组)以及102例血压正常者(对照组)。进行超声心电图检查并连续记录4个心动周期内的室间隔厚度(IVS)、左心房前后径(LAD)、左心室前后径(LVD)、左心房容积(LAV)、左心室射血分数(LVEF)、左房室瓣舒张晚期A峰峰值速度(A),同时测定左心室收缩期峰值应变率(SRs)、舒张早期峰值应变率(SRe)、舒张晚期峰值应变率(SRa),计算其平均值(mSRs、mSRe、mSRa)。结果 3组收缩压、舒张压、IVS、LAD、LVD、LAV、A、mSRs、mSRe、mSRa比较,差异有统计学意义(P<0.05);与对照组比较,高血压组和高血压前期组收缩压、舒张压、LAD、LVD、A、mSRa升高,IVS、mSRs、mSRe降低(P<0.05);与对照组比较,高血压组LAV升高(P<0.05);与高血压前期组比较,高血压组A、mSRa升高,mSRs、mSRe降低(P<0.05)。相关性分析结果显示,高血压组和高血压前期组患者mSRa与LAV呈正相关(r=0.738,P<0.05)。结论超声斑点追踪显像技术检测到高血压前期患者左心房各壁应变率峰值降低,运动舒缩功能变弱,同时左心房辅泵功能代偿性变大。高血压及相关心脑血管疾病应及时在高血压早期进行预防和治疗。

Objective To investigate the value of ultrasound speckle tracking imaging in evaluating left atrial function of patients with prehypertension.Methods 96 patients with hypertension（ hypertension group）,103 patients with prehypertension（ prehypertension group）,and 102 people with normal blood pressure（ control group） who received echocardiography in the Third People＇s Hospital of Huizhou from March 2012 to March 2013,were selected as study subjects.The thickness of interventricular septum（ IVS）,left atrium diameter（ LAD）,left ventricular diameter（ LVD）,left atrium volume（ LAV）,left ventricular ejection fraction（ LVEF）,and the A peak velocity of left atrioventricular valve late diastole phase（ A） within four cardiac cycles were recorded continuously,SRs,SRe and SRa were determined,and the mean values（ mSRs,mSRe,mSRa） were calculated.Results There were significant differences in SBP,DBP,IVS,LAD,LVD,LAV,A,mSRs,mSRe and mSRa（ P〈 0.05）.SBP,DBP,LAD,LVD,A and mSRa in hypertension group and prehypertension group were significantly higher than those in control group,IVS,mSRs and mSRe in hypertension group and prehypertension group were significantly lower than those in control group（ P〈 0.05）.LAV in hypertension group was significantly higher than that in in control group（ P 〈0.05）.The A and mSRa in hypertension group were significantly higher than those in prehypertension group,mSRs and mSRe were significantly lower than those in prehypertension group（ P〈 0.05）.Linear correlation analysis results showed that the mSRa in hypertension group and prehypertension group were positive correlated with LAV（ r = 0.738,P 〈0.05）.Conclusion Through ultrasound speckle tracking imaging techniques,we found the strain rate value of left atrium wall peaks in patients with prehypertension decreased.The movement and diastolic function of left atrium became weaker,while the sub- pumping function of left atrium became stronger.Hypertension and other related cardiovascular and cerebrovascular diseases should be prevented and treated in time in the early stage of hypertension.